Clinical lectures on Neurasthenia.

  • Savill, Thomas Dixon, 1856-1910.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on Neurasthenia. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    CASE OF TRAUMATIC NEURASTHENIA resume his occupation, but was unable to drive, partly by reason of pain in the side, but chiefly by reason of timidity in driving, and on account—though when pressed he could not give a name to them—of the horrible fears which came over him, especially towards the evening. If he attempted to go out after dark a horrible dread seized him, and he shook all over. I did not see him until a year after this (August, 1885), when much the same symptoms still remained. He professed himself to be almost deaf in the right ear, unable to hear a watch until it touched the ear. His vision too, he said, was defective, for he could not see things at the side of him. There was no error of refraction, and the ophthalmoscope revealed nothing. All the organs were normal, but there were signs of an old fracture of two of the lower ribs on the right side, at the seat of pain. He complained also of a feeling of fulness after meals when he felt more tired than usual; the appetite was good and there was no vomiting. The urine was normal. The matter had now come before one of the High Courts, and a considerable sum for damages was claimed, the patient being brought to me for a second opinion. I examined him thoroughly and could find no physical signs, excepting, first, a zone of hypersesthesia around the middle third of both legs; and, secondly, a retraction of the fields of vision, most marked in the right eye. I submitted these signs to repeated tests, and came to the conclusion that they could not be the result of simulation. I also tested his fields of vision on several days and at different hours of the day, and found that they were more retracted towards the latter part of the day, particularly if he had taken, for him, much exertion. Under cross-examination I gave this report at considerable length in court, and full damages were awarded. This case seems to me one of considerable interest, as being entirely due to the shock of the accident. The dyspepsia might perhaps have contributed slightly, but the gastric symptoms were such that they might very well have been part of the neurosis, and they had only come on quite recently. The symptoms came on immediately after the accident, and persisted. They remained also for